Individual
DR. CLAY H WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
043510
GA
207RN0300X
Nephrology Physician
13568
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000749911A
—
GA
05
—
000749911AB
—
GA
05
—
000749911AC
—
GA
05
—
000749911AD
—
GA
05
—
000749911AE
—
GA
05
—
000749911AF
—
GA
05
—
000749911AG
—
GA
05
—
000749911AH
—
GA
05
—
000749911AI
—
GA
05
—
000749911K
—
GA
05
—
000749911M
—
GA
05
—
000749911P
—
GA
05
—
000951915B
—
GA
05
—
000951915C
—
GA
05
—
000951915E
—
GA
01
—
10058037
AMERIGROUP
GA
01
—
1134106925
BCBS-GA
GA
01
—
338224
WELLCARE OF GA
GA
01
—
390005010
RAILROAD MEDICARE
GA
05
—
G43510
—
SC
Enumeration date
12/22/2005
Last updated
11/05/2014
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